864 resultados para meticillin resistant Staphylococcus aureus


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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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A infecção hospitalar (IH) é um grave problema de saúde pública, principalmente em pacientes internados em Unidade de Terapia Intensiva (UTI), devido à gravidade do quadro clínico, uso constante de antimicrobianos e frequência do emprego de procedimentos invasivos. O Staphylococcus aureus (S. aureus) é um dos principais patógenos que coloniza indivíduos saudáveis e responde também, por infecções em pacientes hospitalizados. O presente estudo objetivou a identificação do perfil de suscetibilidade, principais sítios acometidos por infecção e possíveis fatores de risco associados à infecção ou colonização por S. aureus isolados de pacientes e profissionais de saúde da UTI de Hospital de Urgência e Emergência de Rio Branco (HUERB) – Acre. Foi desenvolvido um estudo transversal no período de janeiro a agosto de 2009. Para pesquisa de portadores, foram coletadas amostras biológicas da microbiota dos pacientes e profissionais de saúde. Para o levantamento de casos de pacientes com IH, foram coletadas amostras biológicas dos sítios suspeitos de estarem acometidos, a partir de 72 horas da data de sua admissão, até alta, transferência ou óbito. Dos 62 pacientes inseridos nos estudo, 19,3% foram portadores e 6,4% desenvolveram IH por S. aureus; e dos 35 profissionais, 28,6% foram portadores de S. aureus. Foi a segunda espécie bacteriana mais isolada de pacientes portadores e a quinta mais isolada de casos de IH. Não houve comprovação estatística para as variáveis abordadas no estudo serem consideradas fatores de risco para aquisição de IH por S. aureus. Os sítios anatômicos acometidos por IH por S. aureus foram o trato respiratório (n=2), seguido de corrente sanguínea (n=1). A amostra ponta de cateter foi responsável por 1 isolado. Um (1,6%) paciente desenvolveu IH por MRSA; e 5 (8,1%) pacientes e 2 (5,7%) profissionais foram portadores de MRSA, ocorrência baixa quando se relaciona com os resultados do restante do Brasil e do mundo. Destaca-se ainda, a incidência do MSSA sobre o MRSA e a baixa resistência dos MRSA aos antimicrobianos, demonstrando que na UTI do HUERB, as IH por S. aureus ainda não se constituem um problema de saúde pública. Não houve isolados de S. aureus resistentes à vancomicina, podendo ser considerada uma opção terapêutica para os casos de IH por MRSA. Vale ressaltar a importância desse estudo no Estado do Acre, por constituir o primeiro desta natureza em UTI, envolvendo S. aureus e MRSA.

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Pós-graduação em Doenças Tropicais - FMB

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Aims. To quantify the presence of SCCmec types and virulence genes among Staphylococcus aureus colonizing and infecting patients from a teaching hospital. Methods. We analyzed 225 and 84 S. aureus isolates recovered from surveillance and clinical cultures, respectively. Strains were studied for the presence and type of SCCmec, as well as for several virulence genes. Univariate and multivariable analysis were performed in order to identify predictors of invasiveness (defined as isolation from clinical cultures). Results. The presence of SCCmec types III (OR, 2.19, 95% CI, 1.08-4.45) and IV (OR, 5.28 95% CI, 1.35-20.63) and of genes coding for exfoliative toxin B (etb, OR, 6.38, 95% CI, 1.48-27.46) and Panton-Valentine leukocidin (pvl, OR, 2.38, 95% CI, 1.16-4.86) was independently associated with invasiveness. Conclusions. SCCmec types III and IV and virulence genes are associated with greater invasiveness of S. aureus. Patients colonized with methicillin-resistant S. aureus, as well as with strains harboring etb or pvl, may be prone to develop invasive disease. Infection-preventing strategies should be more intensively applied to this group.

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The objective was to evaluate the performance of surveillance cultures at various body sites for Staphylococcus aureus colonization in pregnant women and newborns (NB) and the factors associated with nasal colonization. For NB, 4 sites were evaluated: nares, oropharynx, perineum, and umbilical stump (birth, third day, and weekly). For pregnant women, 4 sites during labor: anterior nares, anus, perineum, and oropharynx. Nasally colonized patients were compared with colonized only extranasally. Colonization was 53% of 392 pregnant women (methicillin-resistant S. aureus [MRSA]: 4%) and 47% of 382 NB (MRSA: 9%). For newborn patients, the best body site was the umbilical stump (methicillin-susceptible S. aureus [MSSA]: 64%; MRSA: 68%) and the combination of nares + umbilical (MSSA: 86%; MRSA: 91%). Among pregnant women, the best body site was the anterior nares (MSSA: 59%; MRSA: 67%) and the combination of nares + oropharynx (MSSA: 83%; MRSA: 80%). A smaller number of household members were associated with MRSA carriage in pregnant women (2.2 +/- 0.6 versus 3.6 +/- 1.8; P = 0.04). In conclusion, multiple culture sites are needed. Control programs based on surveillance cultures may be compromised. (C) 2012 Elsevier Inc. All rights reserved.

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Staphylococcus aureus TenA (SaTenA) is a thiaminase type II enzyme that catalyzes the deamination of aminopyrimidine, as well as the cleavage of thiamine into 4-amino-5-hydroxymethyl-2-methylpyrimidine (HMP) and 5-(2-hydroxyethyl)-4-methylthiazole (THZ), within thiamine (vitamin B1) metabolism. Further, by analogy with studies of Bacillus subtilis TenA, SaTenA may act as a regulator controlling the secretion of extracellular proteases such as the subtilisin type of enzymes in bacteria. Thiamine biosynthesis has been identified as a potential drug target of the multi-resistant pathogen S. aureus and therefore all enzymes involved in the S. aureus thiamine pathway are presently being investigated in detail. Here, the structure of SaTenA, determined by molecular replacement and refined at 2.7 A ° resolution to an R factor of 21.6% with one homotetramer in the asymmetric unit in the orthorhombic space group P212121, is presented. The tetrameric state of wild-type (WT) SaTenA was postulated to be the functional biological unit and was confirmed by small-angle X-ray scattering (SAXS) experiments in solution. To obtain insights into structural and functional features of the oligomeric SaTenA, comparative kinetic investigations as well as experiments analyzing the structural stability of the WT SaTenA tetramer versus a monomeric SaTenA mutant were performed.

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In an attempt to develop a Staphylococcus aureus vaccine, we have applied reverse vaccinology approach, mainly based on in silico screening and proteomics. By using this approach SdrE, a protein belonging to serine-aspartate repeat protein family was identified as potential vaccine antigen against S. aureus. We have investigated the biochemical properties as well as the vaccine potential of SdrE and its highly conserved CnaBE3 domain. We found the protein SdrE to be resistant to trypsin. Further analysis of the resistant fragment revealed that it comprises a CnaBE3 domain, which also showed partial trypsin resistant behavior. Furthermore, intact mass spectrometry of rCnaBE3 suggested the possible presence of isopeptide bond or some other post-translational modification in the protein.However, this observation needs further investigation. Differential Scanning Fluorimetry study reveals that calcium play role in protein folding and provides stability to SdrE. At the end we have demonstrated that SdrE is immunogenic against clinical strain of S. aureus in murine abscess model. In the second part, I characterized a protein, annotated as epidermin leader peptide processing serine protease (EpiP), as a novel S. aureus vaccine candidate. The crystal structure of the rEpiP was solved at 2.05 Å resolution by x-ray crystallography . The structure showed that rEpiP was cleaved somewhere between residues 95 and 100 and cleavage occurs through an autocatalytic intra-molecular mechanism. In addition, the protein expressed by S. aureus cells also appeared to undergo a similar processing event. To determine if the protein acts as a serine protease, we mutated the catalytic serine 393 residue to alanine, generating rEpiP-S393A and solved its crystal structure at a resolution of 1.95 Å. rEpiP-S393A was impaired in its protease activity, as expected. Protective efficacy of rEpiP and the non-cleaving mutant protein was comparable, implying that the two forms are interchangeable for vaccination purposes.